Masarei A G, Wade A, Mars M, Sommerlad B C, Sell D
Great Ormond Street Hospital for Children NHS Trust, London, UK.
Cleft Palate Craniofac J. 2007 Mar;44(2):182-93. doi: 10.1597/05-184.1.
To investigate the controversial assertion that presurgical orthopedics (PSO) facilitate feeding in infants with cleft lip and palate.
Randomized control trial of 34 infants with nonsyndromic complete unilateral cleft lip and palate and 16 with cleft of the soft and at least two thirds of the hard palate. Allocation to receive presurgical orthopedics or not used minimization for parity and gender. Other aspects of care were standardized.
The North Thames Regional Cleft Centre.
Measurements were made at 3 months of age (presurgery) and at 12 months of age (postsurgery). Primary outcomes were anthropometry and oral motor skills. Objective measures of sucking also were collected at 3 months using the Great Ormond Street Measure of Infant Feeding. Twenty-one infants also had videofluoroscopic assessment.
At 1 year, all infants had normal oral motor skills and no clear pattern of anthropometric differences emerged. For both cleft groups, infants randomized to presurgical orthopedics were, on average, shorter. The presurgical orthopedics infants were, on average, lighter in the unilateral cleft and lip palate group, but heavier in the isolated cleft palate group. Infants with complete unilateral cleft and lip palate randomized to presurgical orthopedics had lower average body mass index (mean difference PSO-No PSO: -0.45 (95% confidence interval [-1.78, 0.88]), this trend was reversed among infants with isolated cleft palates (mean difference PSO-No PSO: 1.98 [-0.95, 4.91]). None of the differences were statistically significant at either age.
Presurgical orthopedics did not improve feeding efficiency or general body growth within the first year in either group of infants.
探讨关于术前矫形（PSO）有助于唇腭裂婴儿喂养这一存在争议的观点。
对34例非综合征性完全性单侧唇腭裂婴儿和16例软腭裂且硬腭至少三分之二裂开的婴儿进行随机对照试验。根据胎次和性别采用最小化法分配是否接受术前矫形。护理的其他方面均标准化。
北泰晤士地区腭裂中心。
在3个月龄（术前）和12个月龄（术后）时进行测量。主要结局指标为人体测量学指标和口腔运动技能。3个月时使用大奥蒙德街婴儿喂养测量法收集吸吮的客观指标。21例婴儿还进行了视频荧光透视评估。
1岁时，所有婴儿的口腔运动技能均正常，未出现明显的人体测量学差异模式。对于两个腭裂组，随机分配接受术前矫形的婴儿平均身高较矮。在单侧唇腭裂组中，接受术前矫形的婴儿平均体重较轻，但在单纯腭裂组中体重较重。随机分配接受术前矫形的完全性单侧唇腭裂婴儿的平均体重指数较低（术前矫形组与非术前矫形组的平均差异：-0.45（95%置信区间[-1.78, 0.88]），在单纯腭裂婴儿中这一趋势相反（术前矫形组与非术前矫形组的平均差异：1.98 [-0.95, 4.91]）。在两个年龄阶段，这些差异均无统计学意义。
术前矫形在两组婴儿的第一年中均未提高喂养效率或促进总体身体生长。
